Brandy Moser
Fort Worth,TX
Summary
Service-oriented claims adjuster with expertise in applying creative problem-solving techniques. Proficient in developing efficient and high-quality processes. With [Number] years of experience as a detail-oriented examiner, demonstrates exceptional conflict resolution and negotiation skills, coupled with excellent reporting and research abilities. Possesses a comprehensive understanding of the claims process and verifications, enabling effective navigation and resolution of any claims-related issues.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Workers' Compensation Claims Representative
Texas Health Arlington Memorial
10.2020 - Current
- Examined claims forms and other records to determine insurance coverage.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Documented information gathered in field and uploaded data to company database for efficient processing using Software.
Salesperson
Scentsy
10.2013 - Current
- Worked to build relationships with customers and built potential for additional sales.
- Developed relationships with clients for increased loyalty and repeat business.
- Boosted sales by consistently engaging with customers and addressing their needs effectively.
- Collaborated with team members to reach collective sales goals, fostering a supportive work environment.
Customer Service Representative
UnitedHealth Group
10.2022 - 12.2022
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
Education
Naham
Online07.2024
GED -
Region Sixteen
Amarillo, TX07.2001
Skills
- Workers' Compensation Laws
- Policy Interpretation
- Problem-Solving
- Attention to Detail
- Problem-solving abilities
- Multitasking
- Team Collaboration
- Team Leadership
- Claims
- Claims Processing
- Insurance policy coverage knowledge
- Claims adjustment
- Claims Evaluation
- Report and Records Review
- MS Office
- Coverage Determination
- Payment Processing
- Time management abilities
- Records Review
- Report Writing
- Benefits review
- HIPAA Compliance
- Insurance Verification
- Insurance Billing
- Medical Billing
- Medical terminology knowledge
- HIPAA understanding
- Data entry proficiency
- Collections experience
- File coordination
- Insurance Company Communication
- Analytical and Critical Thinking
- Organizational Skills
- Decision-Making
- Clear Communication
- Updating Customer Accounts
- Correspondence Writing
- Financial Documentation
- Work Planning and Prioritization
- Payment Scheduling
- Task Prioritization
- Self Motivation
Certification
CHAA Certification
Timeline
Customer Service Representative
UnitedHealth Group
10.2022 - 12.2022
Workers' Compensation Claims Representative
Texas Health Arlington Memorial
10.2020 - Current
Salesperson
Scentsy
10.2013 - Current
Naham
GED -
Region Sixteen
CHAA Certification
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